Active NPI
Lyle Dennis Danuloff, PHD
- Clinical Psychologist
- Farmington Hills, MI
National Provider Identifier
1104047935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001664
- Practice address
- 31500 West 13 Mile Road
Suite 100
Farmington Hills, MI 48334 - Phone
- (248) 785-0088
- Fax
- (248) 785-5388
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001664 | MI | Primary |
Addresses
Primary practice location
31500 West 13 Mile Road
Suite 100
Farmington Hills, MI 48334
Mailing address
31500 West 13 Mile Road
Suite 100
Farmington Hills, MI 48334
Phone (248) 785-0088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001664 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104047935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31500 WEST 13 MILE ROAD",
"address_2": "SUITE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48334",
"telephone_number": "248-785-0088",
"fax_number": "248-785-5388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31500 WEST 13 MILE ROAD",
"address_2": "SUITE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "48334",
"telephone_number": "248-785-0088",
"fax_number": "248-785-5388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANULOFF",
"first_name": "LYLE",
"middle_name": "DENNIS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "001664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.